Is Vaccination the End of the Rotavirus Problem in Romania?

Background: In Romania, although there is a Rotavirus vaccine available since 2007, viral acute gastroenteritis with this etiology is still a major cause of hospitalization in infants.

Objective: The aim of our study is to evaluate the trend of Rotavirus infection in hospitalized infants in 2016 vs. 2011.

Methods: We carried out an observational, retrospective study, which included all infants diagnosed with Rotavirus infection in “Grigore Alexandrescu” Emergency Hospital for Children from Bucharest, between January and December 2016. We compared our data with similar ones from a study conducted in the same conditions, during 2011.

Results: During 2016, 710 infants from the gastroenterology department were diagnosed with acute gastroenteritis, 177 with Rotavirus infection vs. 839 in 2011, of which 209 with Rotavirus. There is a significant decrease in the incidence of Rotavirus diarrhea in the past 5 years, 41.9% in 2011 vs. 24.9% in 2016 (p<0.01). There were 93 cases (24.9%) of nosocomial infection with Rotavirus reported in 2011, vs. 48 (24.85%) in 2016. If in 2011, the 3-6 months age group was most frequently affected by nosocomial Rotavirus (54.8% of cases vs. 29.2% in 2016, p<0.01), in the past year, the 6-12 months age group was mainly infected during hospitalization (41.7% in 2016 vs. 21.5% in 2011, p<0.01). The mean duration of hospitalization in 2011 was 6.3 days vs. 5.3 days in 2016.

Conclusion: Although Rotavirus vaccination is not mandatory, the availability of the vaccine on the Romanian market determined a decrease in the incidence of acute gastroenteritis in infants, suggesting an improved strategy in informing the parents. Nosocomial infections with Rotavirus remain a significant problem, probably because of crowded hospitals. Remains exposed to nosocomial Rotavirus the 6-12 months age group, probably unvaccinated infants.